Sunday, March 22, 2020

Perks Of Being A Wallflower Essays - Mental Illness In Fiction

Perks Of Being A Wallflower I really enjoyed reading the book. I liked the way it was written pretty much. Charlie's letters are as intimate as a diary as he shares his day-to-day thoughts and feelings. You can somehow really get to know the narrator - Charlie - and you feel like he is writing all these letters to you. That is very interesting. Yet there are somewhat unrealistic tones, which I noticed some time after reading the book, because my first impression was how incredibly realistic it was. Charlie is only portrayed as the nice, innocent teenager. He does some things wrong, but in the end is near perfect. Even though he is screwed up, your compassion for Charlie is overwhelming, and you seem to forget that the book does not seem that real. Besides, in my opinion some of the letters are too "bookish". However I still think the book is insightful, true and pretty sad. 2. The language was colloquial and very easy to understand. 3. There are lots of impressing parts, but the one I liked most is when Charlie is telling a poem at a Christmas party to all his friends. I loved the poem because it is that sad but, however, true, I think. It is about growing up and how things change when you are not anymore the lovely little child but have become a young adult. In my opinion it is written in a very sad, nevertheless nice way. Later on Charlie finds out the poem was written by a boy just before he killed himself. He feels really sad about this. 4. "The perks of being a wallflower" is the story of what it is like to grow up in high school. Charlie, a 15-year-old freshman, is writing letters who cover his first year in high school to an unknown person. Charlie encounters the same struggles that many kids have to face in high school - how to make friends, family tensions, a first relationship, experimenting with drugs - but he also has to deal with his best friend's recent suicide. With the help of a teacher who recognises his intuition , and his two older friends, the seniors Patrick and Samantha, Charlie begins to be contented with his life. Yet not for a long time - depressed when all his friends prepare for college, Charlie has a catatonic breakdown, which resolves itself neatly and reveals a long-repressed truth about his Aunt Helen. Nevertheless, he makes it back in due time, ready to face his sophomore year and all it may bring. 5. In this book there is not really a climax because Charlie only tells about his life. Though there happen several important things that change his life a lot. One of them is when Charlie's first relationship with Mary-Elizabeth, a good friend of Sam, ends miserably because Charlie remains compulsively honest about the fact that he truly loves Sam and not Mary-Elizabeth. That hurts Mary-Elizabeth very much, and somehow the whole group of his friends more or less does not want to see him for about one month. By the time Charlie realises how he did Mary-Elizabeth wrong and endangered the friendship of Sam and her. He starts to see how much his friends really mean to him and how much he needs them. Charlie remembers the beginning of the year, before he got to know Sam and Patrick, and how lonely he felt then - so lonely that he started writing letters to an unknown person. He finds out what friendship really means. That was very impressing and I really could empathise with Charlie. 6. The ending really took me by surprise. You could see from Charlie's letters that he was emotionally unstable, yet I never thought he would have such a breakdown and have to go to hospital for two months. 7. I think Charlie was in some way like me. I did not dislike anyone of the characters, they were all pretty sympathetic, I think. Charlie: Charlie is the third child in a middle-class family. His older brother plays football at Penn State and his older sister worries a lot about boys. Charlie attends high school, he is a freshman and by no means popular. He is a shy boy, introverted and easily influenced. Patrick and Sam think he is a wallflower. He is also very na?ve and honest, which makes him a lot of problems later on. Charlie is a thinker, but he thinks too much, which sometimes leads to

Thursday, March 5, 2020

Euphemisms for Job Loss

Euphemisms for Job Loss Euphemisms for Job Loss Euphemisms for Job Loss By Maeve Maddox The unfortunate occasion of being dismissed from employment can be expressed in numerous ways. Some of the more familiar expressions are: to be made redundant to receive a pink slip to be dismissed to be discharged to be laid off to be let go to lose one’s job to be fired to be got rid of to be booted out to be given the boot to get the sack to be sacked to be given one’s marching orders to get the ax/axe These homely expressions still appear in headlines: Pentagon gives pink slips to thousands of soldiers, including active-duty officers Digital strategy to axe tens of thousands of central government jobs Thousands of Woolworths staff face sack in Christmas week Thousands of Doctors Fired by United Healthcare However, when it comes to carefully worded announcements issued by people doing the firing, today’s reader must exercise advanced skills of textual interpretation. Here are some of the ways firing people is described by public relations officers: realigning the workforce reallocating resources focusing on involuntary attrition rightsizing the company offering unpaid leave with the option to pursue new employment eliminating redundancy smart-sizing the company redeploying workers rewiring for growth eliminating positions rethinking our future adjusting to shifts in demand rebalancing human capital re-engineering simplifying streamlining going in another direction And my personal favorite: decruiting. decruit (verb): to remove people working for an organization from their jobs because they are no longer needed. Clearly modeled on the word recruit, this poor little misshapen invention is already being used without scare quotes: the phenomenon of companies announcing their various intentions to decruit vast numbers of people.  Ã¢â‚¬â€œStanley Bing, Fortune. Teach leaders what they must know to decruit workers when necessary. –from a brochure for a business leader workshop sponsored by Penn State. Let go of the unalterable agents. If you can’t change their work habits, then change their work place. Decruit them. Let them go. –â€Å"Tips to Lead Your Company to Success,† Miami Association of Realtors. Want to improve your English in five minutes a day? Get a subscription and start receiving our writing tips and exercises daily! Keep learning! Browse the Expressions category, check our popular posts, or choose a related post below:50 Idioms About TalkingBody Parts as Tools of MeasurementArtist vs. Artisan

Tuesday, February 18, 2020

Consumer Purchasing and the Rehabilitation Industry Coursework

Consumer Purchasing and the Rehabilitation Industry - Coursework Example Studies show that consumers have provided the impetus for economic recovery in many countries, including the US. In the wake of the US economic recession following 9/11, for example, the employment rate declined, wages stagnated, personal incomes struggled, but consumers were spending 10 percent more than the levels before the crunch. What happened was the consumers deferred their household mortgage and non-mortgage payments (housing and car loans, mostly) to pay for their daily consumption (Lilly, S. (2005). This means that come hell or high water, the consumer market is always there to lap up any brands that fulfill their needs. But precisely because the economy is in a strait jacket, producers of consumer goods and services need to navigate a minefield of challenges presented by a market made up of consumers who would only part with their hard-earned money if the brands offered to them have enough pulling power to influence their purchasing decisions. Logically, competition has ti ghtened up not only for the consumer market for goods but also for professional services, such that even the latter sector now calls for a branding strategy. The same thing goes for recruitment activities, which now use the branding approach to bag the most capable talents and personnel. Brand i Brand is the sum total of all that is known, thought, felt and perceived about a company, its product or service. It is the process of making products and companies into brands. The consumers' response to brand revolves around its image, and a strong and positive brand image influences consumers into making the decision to purchase. The marketer's principal goal is to build a relationship with buyers, not only for a single sale but also for the long term. The essence of this relationship consists of a strong bond that may be established between brand and buyer. Marketing concepts traditionally associated with the goods industry has been adopted in the service industry due to pressures exerted by rising prices and increased competition. Like all other industries, the rehabilitation industry has been buffeted by changes in technology and local economies. As in marketing for products, promotional efforts for the service sector now also put quality and customer satisfaction at the front burner. This discursive essay puts forward selected facts and theories about branding, the new challenges in marketing brands to a stingier and pickier consumer market, how bonds are established and maintained between brand and buyer, and how brands dictate the pace and scope of consumer purchasing. The essay also tracks down the journey of branding into the service industry, paying particular attention to the rehabilitation sector, which by necessity has evolved from its purely voluntary configuration into an industry as highly competitive as the market for consumer goods. II. Literature Review Haynes, A., et al. (1999) enthuse at the comprehensive brand presentation (CBP) technique, a formalized approach that aligns the manufacturing and

Monday, February 3, 2020

Training Manuals at Strident Marks Essay Example | Topics and Well Written Essays - 500 words

Training Manuals at Strident Marks - Essay Example Through its IPO, the company exposes itself to public scrutiny and speculation. The company's decision to venture into other profitable products further requires a finance department which will ensure that only those lucrative investments are pursued. Thus, the role of its finance department becomes more emphasized. The training module which will be given to members of that functional area should be designed so as to guide the new employees in conducting valuation analysis. It is recommended that the training module be composed of three distinct parts: the role of the financial department in attaining the goals and objectives of Strident Marks; the different valuation techniques and their applications; and including qualitative issues in valuation analysis. This paper believes that in order for the employees to appreciate their jobs, they should be able to place themselves within the organization. It is imperative that the training manual shows especially to the new employees their essential role in the organization. Doing this will further boost the morale of the employees and motivate them to do their jobs. Seeing one's place in the organization will enhance the commitment of employees specially the new ones. The next two parts will be the

Sunday, January 26, 2020

Indias Rise in Economics and the Challenges it Faces

Indias Rise in Economics and the Challenges it Faces India is not, by a long way a regional power, let alone a global power. That it is necessary to state this obvious fact is a testament to the power of public indoctrination. There is a huge gap between India and the developed world. According to the World Bank, Indias Gross National Income (GNI) in 2009 was $793 billion, compared to the USs $12.95 trillion. India, with 17 per cent of the worlds population, accounts for less than 1.7 per cent of the worlds income. Thus Indias per capita GNI was $1180, compared to the USs nearly $47,240. Even South Koreas per capita GNI was over $19,880. Indias situation is slightly better in terms of Purchasing Power Parity (PPP) but even Indias PPP per capita income is ranked 154th in the world  [1]  . For all the rosy projections of rapid growth by India and other Asian countries by 2020, the USs National Intelligence Council admits that per capita income in most (Asian) countries will not compare to those of Western nations. Human Development The situation is far worse in terms of human development. In the UNs Human Development Index, this claims to be a composite of various factors, such as health, education and income, India ranks 119th among 175 countries. Indias under-five mortality rate per 1,000 live births is 69, that is, one in fourteen children die before the age of five. Its maternal mortality ratio per 100,000 live births is 230, compared to 38 for China  [2]  . We are constantly told that poverty in India is declining, and a great industry has sprung up of academic treatises to show how fast poverty is declining. However, these treatises have reduced poverty by defining the term so that it no longer relates to whether or not people get their minimum requirements of calories. The official National Sample Survey of 2005 revealed that three-fourths of Indias rural population and half the urban population did not get the minimum recommended calories. This is confirmed by nutritional and health surveys, which reveal the following: more than two-fifths of the adult population suffer from chronic energy deficiency, and a large percentage are at the border of this condition; half Indias women are anaemic; half its children can be clinically defined as malnourished (stunted, wasting, or both). Within India half of our rural population or over 350 million people are below the average food energy intake of SSA (Sub-Saharan Africa) countries.  [3]   Poverty as such is not directly observed: the National Sample Survey (NSS) gathers responses to a questionnaire regarding consumption, and the poverty estimates are then derived (after making various assumptions) from this data. But the same NSS directly observes that employment growth plummeted between the last two surveys (1993-94 and 1999-2000). Now, it is virtually impossible for poverty to have declined if unemployment grew sharply, and the methodology of any study that claims poverty has fallen should be questioned. The sector of the countrys economy has seen breakneck growth in the past decade: the provision of software services and business process outsourcing services to foreign (principally US) firms. However, that sector accounts for 0.25 per cent of the labour force. Where are the rest? Nearly half of Indias total working-age population (15-59 years of age) is unemployed, most of it not even counted as part of the labour force. While agriculture continues to employ the majority of those considered employed, it accounts for less than a quarter of the national income, and that share continues to shrink. No Industrial Transformation National income is conventionally divided into three sectors- agriculture, industry and services. All the countries in the developed world passed from being predominantly agricultural economies to being predominantly industrial economies. It was only after industry had brought these entire economies (including their agriculture) under its sway, commodities became vastly more plentiful than in the past, and the economic surplus grew massively, that these economies could sustain growth in the share of services. Today, industry accounts for the largest share of GDP in the economies of China, South Korea, Taiwan, Malaysia, Indonesia, and Thailand, as much as 56 per cent in the case of China. In Indias case, however, the share of industry is low just 28.2 per cent in 2009  [4]  . Industry has never been the dominant sector of the Indian economy. Moreover, its share of GDP has not been increasing, but is stagnant or shrinking. And Indian industrys share of employment is just 17.6 per cent. Indeed, in the two commodity-producing sectors agriculture and industry one cannot find any miraculous takeoff in growth during the period of reform. But one should beware of drawing sweeping conclusions on the basis of two or even three years figures. And while the services sector has led growth over the past two decades, so that it now accounts for 54.6 per cent of GDP, much of the services sector (e.g. growth of police and armed forces, the explosion of financial sector and real estate activity) has no tangible benefit for the people at large. It is true that certain Indian firms (or Indian units of foreign firms) have attained world standards in quality of output, and with their lower labour costs may become highly competitive exporters. Glowing press reports of such units convey the sense that the Indian economy has undergone a take-off. However, these firms are generally dependent on imported capital goods and are strongly linked to export markets; they have few linkages to the rest of the Indian economy. They remain islands in the large sea of underdeveloped India. Contrast this with the transformation of the economy that would take place with the rapid development of industries catering to domestic demand for items of mass consumption. That would create demand for raw materials and indigenous capital goods, in the entire process generating huge employment and promoting indigenous technological know-how.  At any rate, India accounts for less than one per cent of world exports. High technology goods constitute ju st five per cent of its exports. Indias rapid increase in oil imports (and Indias high-profile efforts to secure long-term oil and gas supplies from abroad) is being held up as a sign of its rapid economic growth. It actually is a sign of the absence of national planning. Much of the growth in oil consumption is on account of the great boom in private automobiles. This is in turn the result of the failure of public transport, growing income inequalities, and the massive expansion of cheap credit for car purchases. Moreover, rapid growth of oil imports signifies not the growing strength but the growing vulnerability of the Indian economy. Genuine national planning would have ensured instead (i) restraint on consumption (through the expansion of railways for goods and passenger transport, expansion of public transport in cities, and a variety of energy conservation investments), and (ii) a programme of investment to develop and use the countrys oil, gas and plentiful coal resources effectively and economically. A comb ination of such measures could have greatly reduced the countrys dependence on oil imports. Instead, the share of oil in Indias energy is growing, and the share of imports in its total oil consumption is on course to reach 90 per cent or more in some years. In the last few years, large foreign capital inflows and the booming foreign exchange earnings of the IT sector have resulted in the rapid growth of the countrys foreign exchange reserves. As a result, the Government has liberalised foreign investment by Indian firms. Thus a number of Indian firms have been investing abroad, in many cases acquiring foreign firms. This phenomenon has generated considerable excitement in the business press, which point to it as further evidence of Indias new global status: now, they claim, Indian firms too are multinational corporations. Indeed, for two years, 2003-04 and 2004-05, India ran a current account surplus, which means that it was a net capital exporter. However, much as this may be good business sense for the firms which are making them; but in general they run contrary to the requirements of national economic development. India is not a capital-surplus economy, but an underdeveloped, capital-starved one, with large resources lying idle for lack of investment. It makes no economic sense to export capital from such a country. Indian capitalists may earn financial returns from their investments abroad, but such returns will give paltry stimulus to the Indian economy, whereas investment in manufacturing within the country stimulates demand, productive activity and employment in a number of sectors, with far-reaching benefits for the whole economy. India- A Knowledge Economy As part of the propaganda about Indias emerging as a global power, we are told ad nauseam that India is a knowledge economy, an information technology (IT) superpower, and the like. The truth is that adult literacy in India is just 61 per cent; on this score, it ranks 146th out of 177 countries in the UNs Human Development Index   (that is, many countries with much lower per capita income had much higher literacy levels than India for example, much of desperately poor sub-Saharan Africa). In recent years, on the recommendation of the World Bank, the Indian government has focussed its meagre education expenditures increasingly on primary education, largely abandoning secondary and higher education (as if they were a luxury). Yet official data tell us that 42 per cent of children enrolled drop out before completing primary education (I-V). Another 19 per cent, according to official data, drop out  before completing upper primary education (VI-VIII). And according to Cens us data, 43.5 per cent of the children between the ages of five and nine are not in school. More perturbing is the quality of education that is being imparted in government schools. It is so dismal that half the children in Class IV in government schools in Mumbai cannot do the arithmetic calculations required of a Class I student. When put to the test, 18 per cent of students attending Classes II to V in Andhra Pradesh couldnt do single-digit additions while only 12 per cent managed single-digit subtractions. Higher education, which the Government has increasingly abandoned to a rapacious private sector, is out of the reach of all but a small section. At any rate, the infrastructure and staff of many of the new private institutions are appalling, and thus the degrees imparted to a large percentage of graduates may not be worth the paper they are printed on. Research And Development According to the official publication Research and Development Statistics (2004-05, the latest edition), Indias expenditure on R D has been falling as a share of GDP, from 0.87 per cent in 2000 to 0.77 per cent in 2005. Let us look more closely at this R D expenditure. First, the Indian private sector does not account for much of it. According to official figures, eighty per cent of R D expenditure was carried out by the Government. This was largely not for productive purposes, but for military purposes: 32 per cent on direct military research, 21 per cent on space research (much of which actually serves the missile programme) and 12 per cent on atomic energy (much of which actually serves the nuclear weapons programme). Even allowing for some genuine space and atomic energy expenditures, at least half of R D expenditure in India appears to be for military purposes. To be able to project power, we bought Admiral Gorshkov from Russia and named her Vikramaditya. But where is the sh ip? Where is that power on high seas? Our horizon does not even show the outline of a carrier. The Arihant (the lead ship of Indias Arihant class of nuclear-powered submarines) has not been armed as yet, and we do not have an indigenously manufactured fighter/bomber. Nor do we have the Missile regime that makes the military might of a Regional Power credible. The showpieces of defence R D the Main Battle Tank project (started in 1974) and the Light Combat Aircraft project (started in 1983) have yet not been completed, and, after the expenditure of billions of rupees each, the chances of their actually being inducted into the armed forces are dwindling. For example, the air force is now in the international market for a mammoth order of 126 fighter planes, at a cost of over $6 billion. How then can we call ourselves a Regional Power? To absorb foreign technology properly (in such a fashion that one can further develop it), R D expenditures need to be multiples of technology payments. And finally, much of what passes under the name of R D in Indian industry is merely classified so for tax saving purposes, and actually consists of adaptation of products to local conditions, or even merely quality control. By conventional measures of scientific output, Indias performance is dismal. The standard database in this regard is the US-based Science Citation Index (SCI). In 1980, around 40 Indian journals were indexed in the SCI; this figure has fallen to 10, or just 0.3 per cent of all SCI-indexed journals. In 1980, nearly 15,000 scientific papers from India were indexed in the SCI; this figure fell over the next two decades to just over 12,000 (Chinas figure grew from under 1,000 to over 22,000 during the same period). Indias share of the worlds total research papers published in SCI-indexed journals was just 1.79 per cent in 2002. Finally, Indias world ranking in the SCIs citation impact (the number of times a paper is cited by others) has fallen to an abysmal 119 out of 149 countries listed. The IT sector Indias much-vaunted Information Technology (IT) sector is composed of two parts: the software sector, and the IT-enabled sector (ITES). In both cases, work that was earlier done in the developed world, particularly the US, has been outsourced, or contracted out, to locations in India. In the case of the ITES, the activities outsourced include call centres, medical transcription, data entry, ticket-reconciliation, claims processing, credit card administration, and such other routine office work as can be performed at remote locations. While this work requires knowledge of English, it does not require superior education or skills. Indeed, some of it is so mechanical and repetitive that it is in danger of being eliminated: Optical-character-recognition software is automating the work of Indian data-entry workers. Electronic airline tickets are eliminating some of the ticket-reconciliation work airlines carry out in India. Eventually, natural-language speech recognition is likely to automate some of the call-centre work that is currently going to India. Other countries too are entering the same business, particularly those once colonised by an English-speaking country: the call-centre business is booming in the Philippines.   This is obviously not high-technology or knowledge-based work; new information-and-communications technology has merely made it possible to carry out such work at remote locations. The sole reason for outsourcing such work is that wages for it in India are a fraction of those in the developed world (according to Deloitte Research, one-tenth), yielding massive savings to US and UK corporations. The jobs threatened in those countries are primarily ones that already pay low wages because they require low skills; by outsourcing to India, firms are able to drive their costs even lower. The same applies for the software sector. It is true that Indias annual production of IT engineers is larger than that of the US. However, Indian engineers are employed in relatively low-value work: the less-creative software jobs are the ones being moved offshore: bug-fixing, updating antiquated code, and routine programming tasks that require many hands. The software pyramid, shows a structure with a few thousand architects at the top, followed at successive levels of skill and pay by researchers, consultants, project managers, business analysts, and finally basic programmers. The last categories are the foot soldiers in the information economy, who write codes for applications and update and test them. It is a part of this lowest category that has been off shored, much of it to India. Indian software firms manage applications of programmes owned by multinational software giants; but Indian firms produce virtually no copyrighted programmes which are sold to a large number of customers, and earn a continuing stream of revenue. Rather, both the hardware and the software they use are imported. American investments in India, especially in new technology areas, will help American companies to reduce costs and become more competitive globally. Equally, Indias earnings from these investments will lead to increased purchases from the US. The information technology revolution is built primarily on US computer-related technology and hardware. India is thus not a knowledge economy but a low-wage economy, distinguished from other such by its colonial heritage, English. It does not command increased international status by virtue of its economic strength; rather, the publicity about its emergence as a power is an outcome of conscious US policy.

Saturday, January 18, 2020

Reflective Assignment on A Simulation for Cardiac Arrest Essay

Simulation-based nursing education has increased and become a more popular approach for clinicians or educators. It provides a real-life situational experience for students to practice skills, applies critical thinking and makes the decision throughout the simulation. This article is a reflection journal after a simulation for cardiac arrest. Reflection learning has been described as a process of critically reviewing experience from practice so that it may be used to inform and change future practice in a positive way (Bulman, 2008). In this simulation-based resuscitation reflection, the effectiveness of using of the Situation-Background-Assessment-Recommendation (SBAR) framework during communication between allied health care professionals, teamwork during resuscitation and methods of collecting history from patient and patient will be discussed. Situation-Background-Assessment-Recommendation (SBAR) framework. In this simulation, the nurse communicated with a physician by using traditional way to report patient’s condition via phone. Physician promoted and obtained information. SBAR is a communication model which includes Situation, Background, Assessment, and Recommendation. The use of SBAR promotes quality and patient safety by setting shared expectations in terms of what is communicated. SBAR allows for efficient and predictable sharing of information by creating a shared mental model (Shapiro, J. 2017). It has become very popular among healthcare setting, especially between physicians and nurses. It is an effective way of communication for healthcare professionals and allows for transferring of important information. The SBAR framework is considered by nurses and physicians to be an effective method for organizing the handoff report (Stewart, 2016). A study showed improved perceptions of communication in nurse-to-nurse and nurse-to-physician sceneries by using pre/ post-SBAR implementation questionnaires (Blom, Petersson, Hagell, & Westergren, 2015). Hailu, Kassahun, & Kerie (2016) founded that communication failure between nurse and physicians was one of the leading causes of preventable patient injuries, complications, death and medical malpractice claim. Use of SBAR framework has been a method which can overcome this communication problem, Thus, using of SBAR framework has two major implication in future. First, nursing education should include appropriate use of SBAR framework which can be used for effective communication at clinical areas (Stewart, & Hand, 2016). Same education will provide the same perception of SBAR framework and provide better application of this framework. Second, Stewart and Hand (2016) also suggested that SBAR framework should be applied by nurses as a guideline for all handover communication between nurses and physicians, inter/intra department or institutions. Inpatient safety, effective communication during patient handoffs is the nursing priority (The Joint Commission, 2015). TEAMWORK In this simulation, endotracheal intubation was done in different manners. In the first team, all members did endotracheal intubation and stopped chest compression. In second group one person struggled and did an endotracheal intubation. Teamwork was not done in this simulation. As this procedure should need two persons at least. Teamwork and leadership were lacked. Resuscitation is a stressful, time-pressured procedure, and unfortunately if often futile. Care of a patient in the emergency setting is particularly prone to errors and adverse events for a variety of reasons. These include the time-pressured decision making, increased rate of patient interventions, and the fact that teams are â€Å"assembled† by the emergency call that may have never worked together, or even met each other, before. (Walker, 2013). Even though there were a well-known cardiopulmonary resuscitation(CPR) algorithms among health care professionals, the results of CPR were remained poor (Hunziker, Johansson, Tschan, Semmer, Rock, Howell, & Marsch, 2011). Hunziker et al. (2011) indicated some other factors like teamwork and leadership affect the application of CPR algorithm and hence the performance of CPR, besides the technical skills of the resuscitation team members. Research has shown that teamwork and leadership training has been shown to improve subsequent team performance during resuscitation (Hunziker et al., 2011). History taking History was taken from a patient in this simulation. The nurse used OLDCART known as O-Onset, L-Location, D-Duration, C-Characteristics, A- Aggravating factors, R-Relieving factors, T-Treatment to obtain a history of present illness from the patient. Nursing care encompasses knowledge, skill, and competence to enable holistic patient assessment (Office of the Chief Nursing Officer (OCNO) (Ireland), 2016). Professional nursing care involves capturing, analyzing and interpreting patient information (OCNO, 2016), initially through the patient’s health history. Obtaining a detailed clinical history is a core competency of many advanced nursing roles (National Council for the Professional Development of Nursing and Midwifery (NCNM) (Ireland), 2008; Tagney and Younker, 2012; Apau, 2010; Quigley and Martin, 2013), in combination with the advanced physical assessment. Taking a comprehensive health history is a core competency of the advanced nursing role. The purpose of the health history is to source important and intimate knowledge about the patient, their lifestyle, social supports, medical history and health concerns, with the history of presenting illness as the focus and allow the nurse and patient to establish a therapeutic relationship ( Ingram, 2017). At the beginning of history taking, the nurse had established a therapeutic relationship with the patient. During assessing of chest pain, pain score was used to evaluate the severity of pain. This provided a common language between nurses and physicians. CONCLUSION Errors in communication continue to be a contributing factor in adverse patient events in healthcare systems (The Joint Commission, 2015). The systemic nature of the problem of miscommunication between healthcare providers supports the need for a standardized communication method. The SBAR tool is a simple, effective method for communication that operates across disciplines and is well- received by healthcare professionals (Blom et al., 2015; Nagammal et al., 2017). Use of the SBAR tool thus should be implemented systematically to improve healthcare communication and create a safer patient care environment. A study had shown that communication was still affected due to structure absence, loss of information and low adherence after implementation (Ludikhuize, de Jonge, & Goossens, 2011). As part of professional obligation and for a better outcome of patients, nurses and physician should discuss their communication level while giving care to the patient, communicate openly, in mutual professional respect, and share patient’s information. Moreover, these professional needs play a vital role in creating smooth and a well-defined communication channel (Hailu, Kassahun, & Kerie, 2016). Teamwork is an essential non-technical skill in the perioperative environment. Along with other key factors, it plays a vital role in safe and effective practice and should be fostered and encouraged through appropriate training and education. The model of teamwork training best suited to the perioperative environment is less clear. Great care must be taken to ensure that any model used offers the maximum benefit to patients and staff in terms of perioperative safety. Superimposing popular management techniques and training models from other sectors onto this inter-disciplinary, time and safety critical environment may not achieve the desired outcomes or represent the good use of limited resources. Recommendations It is clear that more research is required into what is the best model of teamwork training for the perioperative environment. While there have been some controlled studies, a methodology for robust RCTs must be developed in order to bridge the existing knowledge gaps around the clinical effects of teamwork training. Similarly, longer-term effects and the level of need for ongoing training and mentorship must be established. The key recommendation, however, relates to inter-disciplinary team training at the pre-clinical stage. The evidence set out in this paper suggests that inter-disciplinary training in simulation offers a range of benefits to perioperative staff, particularly in the areas of communication, cooperation, and team building. Similarly, interdisciplinary learning in healthcare education appears to promote collaborative working and greater understanding of professional roles. In the experience of the author, however, medical students do not take part in the simulated perioperative exercises which are a key aspect of the training and education of operating department practitioners. The integration of medical students at this level is something which is highlighted in the literature as potentially important in breaking down stereotypes and challenging the establishment of the medical hierarchy. Introducing interdisciplinary training which includes medical students, nursing students, ODP stude nts and allied healthcare students working together in simulated scenarios, could help to demystify aspects of the perioperative environment and to address barriers to teamwork and communication before they become established. Further research is required to explore the optimum form and duration of this approach to learning and to establish what if any, effects this has on the future clinical practice of participants. In this respect, the student environment would serve as an excellent testing ground. Roche, F. (2016) We propose that further studies on the effects of team interactions on the performance of complex medical emergency interventions such as resuscitation are needed. Future efforts to better understand the influence of team factors (e.g., team member status, team hierarchy, handling of human errors), individual factors (e.g., sex differences, perceived stress), and external factors (e.g., equipment, algorithms, institutional characteristics) on team performance in resuscitation situations are critical to improve CPR performance and medical outcomes of patients. (Hunziker et al., 2011).

Friday, January 10, 2020

Schema Theory

A schema describes an organized pattern of thought or behavior. Scripts are schemas which provide information about a sequence of events. Self-schemas organize information we have about ourselves, such as our strengths and weaknesses. The last is the social schema, which represents information about groups of people, and this is how stereotypes are also developed. Bartlett (1932) wanted to look at the effect that schemas have on memory. He had his participants read â€Å"The War of the Ghosts†. the 1st participant read the original story, and then wrote it on paper.Then a 2nd participant, reads whats been written by the 1st participant. Then the 2nd reproduces it on paper for the 3rd participant and so on. In repeated reproduction, the same participant reproduces the story 6 or 7 times. Bartlett found that as the reproductions went on, the stories became shorter and that certain details had been left out or changed. These changes were in an effort to make the story more compre hend-able from within the participants experiences and cultural backgrounds. For example the word canoes became boats, and hunting seals became fishing. Your brain also fills in blanks based on ones existing schemas.Your memory is processed into three main stages; which are encoding, storage, and retrieval. Encoding is when u put the memory into your mind. Storage is maintaining it in your mind. Retrieval is using what you saved in your mind. Cohen (1993) criticized schema theory, saying that the concept of schemas is too vague to be useful. However, many researchers use schema theory to explain cognitive processing. Anderson and Pichert did an experiment to investigate if schema processing influences both encoding and retrieval. The results showed schema processing influenced both.